Objective:? To analyse the efficacy of edaravone combined with nimelidine in treating chronic cerebral ischemic dizziness. Methods:? Eighty-six patients with chronic cerebral ischaemia-induced dizziness admitted to our hospital between January 2021 and January 2025 were randomly assigned to either the monotherapy group (43 patients, receiving edarbinone) or the combination therapy group (43 patients, receiving edarbinone plus nimelide). Efficacy, haematological rheology, neurocytokine levels [brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neuron-specific enolase (NSE)], oxidative stress markers [malondialdehyde (MDA), superoxide dismutase (SOD)], and inflammatory cytokine levels [interleukin-6 (IL-6), interleukin-23 (IL-23), tumour necrosis factor-α (TNF-α)].Results: The overall response rate in the combined group (93.02%) was significantly higher than that in the single-therapy group (76.74%) (P < 0.05). Compared with patients in the single-therapy group at discharge, patients in the combined group exhibited significantly higher blood flow velocities in the basilar and vertebral arteries (P < 0.05). Compared with patients in the single-therapy group at discharge, patients in the combined-therapy group exhibited significantly elevated serum BDNF and NGF levels, and significantly reduced NSE levels (P < 0.05). Compared with patients in the single-therapy group at discharge, patients in the combined-therapy group demonstrated significantly reduced serum MDA levels and significantly increased SOD levels (P < 0.05). Compared with patients in the single-therapy group at discharge, patients in the combination therapy group exhibited significantly reduced serum IL-6, IL-23, and TNF-α levels (P < 0.05).Conclusion: Combination therapy with edaravone and nimelidine for chronic cerebral ischaemia-induced dizziness improves haemorheology, regulates neurocytokine expression and oxidative stress imbalance, and alleviates inflammatory responses, yielding favourable clinical outcomes.